Abstract：
BACKGROUND: Case management has been regarded as the front line of necessary change for fragmented healthcare system.
OBJECTIVE: This study proposed a case management intervention that is suitable for Chinese colorectal cancer patients and explored its effectiveness over a 12-month follow-up.
METHODS: A quasi-experimental study was conducted in an oncology hospital in China. A total of 188 patients were recruited from May 2015 to February 2017; 85 patients in the control group and 80 patients in the intervention group were included in data analysis. The intervention group was managed for 1 year by a case manager who organized the multidisciplinary team, provided regular assessment, a consulting service and referrals. Quality of life, anxiety and depression, symptom distress, treatment adherence and unplanned readmission rates were measured.
RESULTS: Repeated measurement ANOVA showed significant intervention and time effects in global quality of life, anxiety and depression, symptom distress and oral chemotherapy adherence. The intervention group showed statistically significantly better overall treatment adherence and lower unplanned readmission rate.
CONCLUSIONS: Nurse-led case management was effective in improving psychosocial outcomes, treatment adherence and unplanned readmission rate of colorectal cancer patients. A case management model is feasible and effective in colorectal cancer patients and in hospital-dominated healthcare systems where primary care is underutilized.
OBJECTIVE: This study proposed a case management intervention that is suitable for Chinese colorectal cancer patients and explored its effectiveness over a 12-month follow-up.
METHODS: A quasi-experimental study was conducted in an oncology hospital in China. A total of 188 patients were recruited from May 2015 to February 2017; 85 patients in the control group and 80 patients in the intervention group were included in data analysis. The intervention group was managed for 1 year by a case manager who organized the multidisciplinary team, provided regular assessment, a consulting service and referrals. Quality of life, anxiety and depression, symptom distress, treatment adherence and unplanned readmission rates were measured.
RESULTS: Repeated measurement ANOVA showed significant intervention and time effects in global quality of life, anxiety and depression, symptom distress and oral chemotherapy adherence. The intervention group showed statistically significantly better overall treatment adherence and lower unplanned readmission rate.
CONCLUSIONS: Nurse-led case management was effective in improving psychosocial outcomes, treatment adherence and unplanned readmission rate of colorectal cancer patients. A case management model is feasible and effective in colorectal cancer patients and in hospital-dominated healthcare systems where primary care is underutilized.
摘要：
背景：病例管理已被视为零散医疗保健系统必要变革的前线。
目的：本研究提出了一种适用于中国结直肠癌患者的病例管理干预措施，并在12个月的随访中探讨了其有效性。
方法：在中国某肿瘤医院进行了一项准实验研究。2015年5月至2017年2月共纳入188例患者，纳入对照组85例患者和干预组80例患者进行数据分析。干预组由一名病例经理管理1年，该病例经理组织了多学科小组，提供定期评估，咨询服务和转介。生活质量,焦虑和抑郁,症状困扰，测量治疗依从性和非计划再入院率.
结果：重复测量方差分析显示，全球生活质量的干预和时间效应显著，焦虑和抑郁,症状困扰和口服化疗依从性。干预组总体治疗依从性明显较好，非计划再入院率较低。
结论：护士主导的病例管理在改善社会心理结局方面是有效的，结直肠癌患者的治疗依从性和非计划再入院率。病例管理模式在结直肠癌患者和初级保健未得到充分利用的医院主导的医疗保健系统中是可行且有效的。
目的：本研究提出了一种适用于中国结直肠癌患者的病例管理干预措施，并在12个月的随访中探讨了其有效性。
方法：在中国某肿瘤医院进行了一项准实验研究。2015年5月至2017年2月共纳入188例患者，纳入对照组85例患者和干预组80例患者进行数据分析。干预组由一名病例经理管理1年，该病例经理组织了多学科小组，提供定期评估，咨询服务和转介。生活质量,焦虑和抑郁,症状困扰，测量治疗依从性和非计划再入院率.
结果：重复测量方差分析显示，全球生活质量的干预和时间效应显著，焦虑和抑郁,症状困扰和口服化疗依从性。干预组总体治疗依从性明显较好，非计划再入院率较低。
结论：护士主导的病例管理在改善社会心理结局方面是有效的，结直肠癌患者的治疗依从性和非计划再入院率。病例管理模式在结直肠癌患者和初级保健未得到充分利用的医院主导的医疗保健系统中是可行且有效的。
